Welcome to the new year!
I have a range of new topics for you and we'll start right away with an often neglected but promising area: nutrition and supplements!
Facts about Metabolism in Fibromyalgia (FMS)
In recent years it's become clear that metabolic stress, mediated through free radicals (also called oxidative stress) plays a key role in FMS. These radicals cause an alteration of the pain processing system and can cause pain sensitization. Normally the radicals are mitigated through anti-oxidative defense systems or antioxidants, such as vitamines and trace elements. A chronic imbalance of oxidative stress and antioxidants can lead to an impaired energy production in the cells wich can cause chronic widespread pain and fatigue. It's important to know that the brain is the organ with the highest energy turn over and consumes about 20% of the body's energy. This high energy turnover needs equivalent recovery through proper sleep, relaxation and proper food (i.e. vegetables, fruits etc.)! If you are stressed, don't sleep well and eat unhealthy food your brain cells can get overwhelmed of this metabolic stress and react adversely.
In some studies of FMS there have been reports of deficient trace elements like magnesium, zinc, selenium, and iron deficiency. Other deficiencies have been found in certain amino acids (valine, leucine, isoleucine, phenylalanine), which are protein components. As for testing it's definitely good to have you iron, zinc and magnesium levels checked. The amino acids aren't regularly tested but you can try a supplement for a period of at least 2 months. But of course its best to focus on a diet rich vegetables, fruits, nuts and fish to get a natural intake.
Supplements - Best Evidence
- Chlorella is an algae that contains high concentrations of vitamins, minerals and amino acids and has shown improvements in FMS symptoms in two trials. It also helps detoxification of the body.
- Cellfood is an antioxidant supplement (suspended in a solution) containing trace elements, minerals and amino acids and has been shown to effective for FMS and neurodegenerative disorders.
- CoenzymeQ10 plas a key role in the energy production inside the cells and has been shown in studies to be of benefit in FMS at 200-300mg daily
- Gingko biloba has been shown to alleviate cognitive symptoms and is an adaptogen, that means it helps adapt the body to stress.
- Creatine supplementation has been shown to improve muscle function in FMS.
- Melatonin supplementation has recently showed efficacy in the management of pain in FMS. It's a powerful hormone, not only for sleep regulation but also as an antioxidant and hormone regulator.
- Omega-3-Fatty acids, as in marine fish, are essential essential building blocks and information carriers for the nervous and the immune system. Most people in the western world lack appropriate levels of these fatty acids because of the industrialized food production and exclusion of marine fish in their diet. These Omega-3s also reduce inflammation and might help with mood disorders of there is a lack in the body. At least 1000mg (EPA+DHA) daily are recommended.
- Curcumin is a very powerful spice that is helpful in lots of metabolic processes and also reduces inflammation.
- Other supplements with potential in FMS are: L-Carnitine, magnesium and S-adenosylmethionine
- One of the most potent antioxidants is called astaxanthin and can be found in combination with Omega-3s.
- please be aware that aspartame
So most important of course in healthy nutrition, based on vegetables, fruits, plant oils and fish three times a week. Juicing is powerful alternative to concentrate nutrients. Much more could be said about nutrition and I will post another article soon to elaborate more on this topic.
If you chose to take supplements I suggest you give it a try for at least two months on a regular basis to see if it makes a difference.
I hope this is helpful so far. Feedback, your own experiences and questions are always welcome!
All the best
Marc Fouradoulas, MD